Although rare, there have been reports of semen allergy, also called sperm allergy, in both men and women. This occurs when the body's immune system overreacts when it encounters semen. The white blood cells mistakenly identify proteins in the semen as harmful invaders (such as bacteria or viruses) and launch an attack against it.

Patients who are allergic to semen are allergic to semen in general. Therefore, patients may experience an allergic reaction with other partners.

Females may experience an allergic reaction after having oral, vaginal, or anal sex without a protective barrier, such as a condom.

Males are less likely to develop semen allergies than females. It is possible for males to experience an allergic reaction after oral or anal sex with another male. Males may also develop an allergic reaction to their own semen. This occurs after the patient's semen comes into contact with his blood. This may happen during a vasectomy (surgical procedure used to make a man sterile), testicular torsion (when a testicle twists inside the scrotum), or after an infection or trauma.

Symptoms of an allergic reaction to semen vary. Some patients may experience burning, itching, or reddening of the genitalia.

The allergic reaction may lead to temporary infertility problems. When the white blood cells attack the semen, they may prevent the sperm from reaching the female's egg. It is estimated that less than two percent of fertile couples have semen allergies, compared to 5-25% of couples who do have fertility problems.

However, individuals who are allergic to semen are still able to have children. A process called desensitization, which exposes the patient to increasing amounts of semen over a period of time, has been suggested as a temporary cure for allergies to semen. Patients who want to become pregnant may need to undergo artificial insemination procedures if desensitization is not effective.

Using a condom, which prevents the sperm from entering the body, may help alleviate allergic symptoms. Allergy medications, including antihistamines, have been used to treat and prevent symptoms.

Typically, an allergic response is not triggered the first time the body encounters the semen allergen (protein in the semen that causes an allergic reaction). In fact, some people can be repeatedly exposed to the allergen before an allergy develops. The first time or several times after the body is exposed to the allergen, the immune system becomes sensitized. During this process, the body's white blood cells develop immunoglobulin E (IgE) antibodies to the semen allergens.

Once sensitized, the antibodies quickly detect and bind to the semen allergens the next time they enter the body. These antibodies also trigger the release of chemicals, including histamine, which cause allergic symptoms such as hives, inflammation, and itchy skin, as well as anaphylaxis. Anaphylaxis is a severe allergic reaction that affects many body parts. Symptoms of anaphylaxis include low blood pressure, difficultly breathing, shock, and loss of consciousness. Symptoms can vary from mild to severe and may be life threatening without immediate treatment.

Patients who are allergic to a partner's semen are generally allergic to semen in general. Therefore, patients may experience an allergic reaction with other partners.

Women develop the reaction when they come into contact with a male's semen. This can occur during oral, vaginal, or anal sex.

Males may also develop semen allergies. It is possible for males to experience an allergic reaction after oral or anal sex with another male.

Heterosexual males may also develop also develop an allergic reaction to their own semen. This typically occurs after their blood has come into contact with their own semen. This can happen during a vasectomy (surgical procedure used to make a man sterile), testicular torsion (when a testicle twists inside the scrotum), or after an infection or trauma.

General: Symptoms of semen allergy vary among sensitive patients. The most common symptoms include burning, itching, and swelling of the genitals or areas of the skin that come into contact with the semen.

Hives: Moderate allergic reactions may cause hives. Hives are red, itchy swollen welts on the skin that may appear suddenly and disappear quickly. They often develop in clusters, with new clusters appearing as other areas clear up.

Angioedema: Some allergic patients may develop angioedema. This condition causes swelling in the tissue just below the skin. Angioedema is similar to hives, except it occurs deeper in the skin. The swellings, known as welts, usually appear around the eyes and mouth. They may also be present on the hands, feet, and throat.

Anaphylaxis (anaphylactic shock): In rare cases, a severe allergy reaction called anaphylaxis may occur. Anaphylaxis is a systemic allergic reaction, which means that many parts of the body are affected. Symptoms of anaphylaxis can vary from mild to severe and may be potentially life threatening. The most dangerous symptoms of anaphylaxis are low blood pressure, difficulty breathing, shock, and loss of consciousness, all of which can be fatal. The time lapse between ingestion/or contact with the allergen and anaphylactic symptoms varies among individuals. Symptoms may appear immediately or may be delayed from 30 minutes to one hour after exposure. Symptoms may also disappear and then recur hours later. Once symptoms arise, they progress quickly. Patients who develop symptoms of anaphylaxis should seek immediate medical treatment.

General: If semen allergy is suspected, patients may undergo either a skin test or allergen-specific immunoglobulin (IgE) test to confirm a diagnosis.

Patients who experience symptoms of anaphylaxis should be treated with epinephrine immediately. Because anaphylaxis is life threatening, a diagnosis is not needed to begin urgent medical treatment with epinephrine.

Skin (scratch) test: A skin test is used to determine whether a patient is allergic to the proteins in semen (allergens). During the test, the skin is exposed to the semen allergens and observed for an allergic reaction. If the semen triggers an allergic reaction, the patient will develop reddening, swelling or a raised, itchy red wheal (bump) that looks similar to a mosquito bite. The healthcare provider will measure the size of the wheal and record the results. The larger the wheal, the more severe the allergy.

A skin test is typically conducted in a healthcare provider's office. Skin tests cause minimal, if any, discomfort. The needles used barely penetrate the skin's surface and will not cause bleeding.

Allergen-specific immunoglobulin (IgE) test: An allergen-specific immunoglobulin E (IgE) test, commonly referred to as radioallergosorbent test (RAST®), may also be used to determine whether the patient is allergic to semen. However, this test is less accurate than a skin test. It is usually performed in patients who have coexisting severe skin diseases (like eczema or psoriasis) that make it difficult to interpret a skin test.

During the procedure, a sample of blood is taken from the patient. The blood is then sent to a laboratory that performs specific IgE blood tests. The semen allergen is bound to an paper disc called an allergosorbent. Then the patient's blood is added. If the blood contains immunoglobulin antibodies that identify and bind to the semen, the blood will bind to the allergen on the disc. A radio labeled ANTI-IgE antibody is then added to the disc to measure the level of immunoglobulin E present in the blood. The higher the radioactivity, the higher the level of IgE in the blood and the more severe the allergy.

A qualified healthcare provider will interpret the results of the test. In general, the sensitivity of these tests range from 50-90%, with the average being about 70-75%. The patient will receive test results in about seven to 14 days.

General: A process called desensitization, which exposes the male or female patient to increasing amounts of semen over a period of time, has been suggested as a temporary cure for allergies to semen. Patients must be exposed to semen on a regular basis in order to maintain tolerance to the semen allergen. Patients who want to become pregnant may need to undergo artificial insemination procedures if desensitization is not effective. Allergy medications, including antihistamines, have been used to treat symptoms. Using protective barriers like condoms reduces the risk of semen coming into contact with the body, and therefore, reduces the risk of an allergic reaction in females.

Antihistamines: Antihistamines may be used to alleviate allergy symptoms, including red, itchy skin. Common nonprescription antihistamines include diphenhydramine (such as Benadryl®), chlorpheniramine (such as Chlor-Trimeton®), clemastine (such as Tavist®), and loratadine (such as Alavert® or Claritin®). During a severe allergic reaction, diphenhydramine may be injected into the patient. Commonly used prescription medications include desloratadine (Clarinex®), fexofenadine (Allegra®), cetirizine (Zyrtec®), and hydroxyzine (such as Atarax® or Vistaril®).

Artificial insemination: Individuals who want to have children and are allergic to semen may require artificial insemination to conceive. During the procedure, a sample of the male's semen is collected and the proteins that trigger allergic reactions are removed. Then a healthcare provider will use a thin flexible tube to insert the semen into the woman's uterus.

This procedure is typically performed when the female is ovulating. The patient's blood will be tested at the doctor's office to determine when they are ovulating. These tests detect increased levels of the luteinizing hormone, which is associated with ovulation.

Desensitization: A process called desensitization has been suggested as a possible treatment for semen allergies. According to some researchers, sensitive patients may be able to tolerate semen if they are exposed to increasing amounts of semen over a period of time. There are two types of desensitization available: semen desensitization and protein sensitization.

During semen desensitization, which is performed at a healthcare provider's office, a doctor places increasing amounts of semen from a female's partner into her vagina every 20 minutes. The procedure lasts several hours. In order to remain tolerant of the semen, the patient must be exposed to her partner's semen at least twice a week.

During protein desensitization, semen proteins are injected into the male or female patient's blood. Small doses of the protein from his/her partner's semen are injected into the blood every 10-15 minutes over several hours. In order to remain tolerant to the semen, the patient must be exposed to his/her partner's semen at least twice a week.

Epinephrine: A medication called epinephrine is used to treat a severe allergic reaction called anaphylaxis. Epinephrine is injected into the skin at a hospital. Patients with a history of anaphylaxis should carry an auto-injectable epinephrine (EpiPen®) with them at all times. If symptoms of anaphylaxis appear after exposure to semen, the patient uses the device to inject the epinephrine into his/her thigh. Epinephrine acts as a bronchodilator because it opens the patient's airway. It also constricts the blood vessels, which increases blood pressure. Patients who experience anaphylaxis may also be admitted to the hospital to have their blood pressure monitored and possibly to receive breathing support.

Leukotriene receptor antagonists: Leukotriene receptor antagonists block the action of leukotrienes, which are also important mediators of the allergic response. New leukotriene receptor antagonists, like montelukast (Singulair®) and zafirlukast (Accolate®), can effectively treat allergy symptoms without some of the common side effects like drowsiness. These long-acting medications are taken once daily.

Note: Anaphylaxis is considered a medical emergency that requires immediate medical care. Therefore, integrative therapies should not be used in place of conventional medicine when an individual experiences symptoms of an anaphylactic reaction.

Unclear or conflicting scientific evidence:

Acupuncture: Acupuncture plus point-injection has been found beneficial for the treatment of hives, although more research is needed to confirm these findings.

Needles must be sterile in order to avoid disease transmission. Avoid with heart valve disease, infections, bleeding disorders or with drugs that increase the risk of bleeding (anticoagulants), medical conditions of unknown origin, and neurological disorders. Avoid on areas that have received radiation therapy and during pregnancy. Use cautiously with pulmonary disease (like asthma or emphysema). Use cautiously in elderly or medically compromised patients, diabetics, or with history of seizures. Avoid electroacupuncture with arrhythmia (irregular heartbeat) or in patients with pacemakers.

Traditional or theoretical uses, which lack sufficient evidence:

Burdock: Traditionally, burdock has been used to treat hives. However, there is currently no human evidence on the safety and effectiveness of this use.

Avoid if allergic to burdock or other plants of the Asteraceae/Compositae family (ragweed, chrysanthemums, marigolds, daisies). Avoid with a history of dehydration, diabetes, heart disease, cancer, high blood pressure, or HIV. Stop use before surgeries/dental/diagnostic procedures. Avoid if pregnant or breastfeeding.

Chamomile: Although chamomile has traditionally been used to treat hives, scientific evidence is lacking. Currently, no human trials have evaluated the safety or effectiveness of chamomile for this use.

Avoid if allergic to chamomile or any related plants, such as aster, chrysanthemum, mugwort, ragweed, or ragwort. Stop use two weeks before surgery/dental/diagnostic procedures with bleeding risk, and do not use immediately after these procedures. Use cautiously if driving or operating machinery. Avoid if pregnant or breastfeeding.

Detoxification therapy (cleansing): Detoxification has been suggested as a possible treatment for hives. However, there is currently no scientific evidence on the safety or effectiveness of this use.

In cases of illness, the various forms of detoxification should be used under professional guidance. See specific monographs for precautions and warnings associated with modalities of detoxification.

Kudzu: Traditionally, kudzu has been used to treat hives. However, there is currently no scientific evidence on the safety and efficacy for this use.

Use cautiously with anticoagulants/anti-platelet agents, blood pressure lowering agents, hormones, antiarrhythmics, benzodiazepines, bisphosphonates, diabetes medications, drugs that are metabolized by the liver's cytochrome P450 enzymes, mecamylamine, neurologic agents, and methotrexate. No well-designed studies on the long-term effects of kudzu are available. Avoid if allergic or hypersensitive to Pueraria lobata or members of the Fabaceae/Leguminosae family. Avoid if pregnant or breastfeeding.

Moxibustion: There is limited evidence suggesting that moxibustion may help treat hives. Additional research is needed to evaluate the safety and efficacy of moxibustion for this use.

Use cautiously over large blood vessels and thin or weak skin. Avoid with aneurysms, any kind of "heat syndrome," cardiac disease, convulsions or cramps, diabetic neuropathy, extreme fatigue and/or anemia, fever, inflammatory conditions, and over allergic skin conditions, ulcerated sores, or skin adhesions. Avoid areas with an inflamed organ, contraindicated acupuncture points, face, genitals, head, inflamed areas in general, nipples, and skin adhesions. Use cautiously in patients who have just finished exercising or taking a hot bath or shower. Use cautiously with elderly people with large vessels. Not advisable to bathe or shower for up to 24 hours after a moxibustion treatment. Avoid if pregnant or breastfeeding.

Peppermint oil: Historically, peppermint has been used to treat hives. Further research is needed to determine whether peppermint is safe and effective for this use.

Avoid if allergic or hypersensitive to peppermint or menthol. Peppermint is generally considered safe in non-allergic adults when taken in small doses. Use cautiously with G6PD (glucose-6-phosphate dehydrogenase) deficiency or gallbladder disease. Menthol, which makes up part of peppermint oil, is generally considered safe in non-allergic adults. However, doses of menthol greater than 1 gram per kilogram of body weight may be deadly in humans. Avoid if pregnant or breastfeeding.

Probiotics: Although probiotics have been suggested as a possible treatment for hives, there is insufficient scientific evidence on its safety and efficacy for this use.

Probiotics are generally considered safe and well tolerated. Avoid if allergic or hypersensitive to probiotics. Use cautiously if lactose intolerant.

There is currently no known way to prevent semen allergy. However, there are ways to reduce the risk of developing the allergy and to minimize symptoms.

Males or females who are allergic to semen may take antihistamines, such as diphenhydramine (Benadryl®), to prevent allergic symptoms, including burning or reddening of the genitalia, before oral, vaginal, or anal sex.

Wearing a condom reduces the risk of semen coming into contact with the body and therefore reduces the risk of an allergic reaction.

Males who are considering undergoing a vasectomy should choose qualified surgeons. If semen leaks into the blood during the operation, there is a slight risk that the patient may develop an allergy to his semen.

Individuals with a history of anaphylaxis should carry an autoinjectable epinephrine device (known as an EpiPen®) with them at all times. A trained family member or friend may help the patient administer the epinephrine, if necessary.

It may be difficult for patients who are allergic to semen to have children. This is because the white blood cells attack the sperm when it enters the body, significantly reducing the chance it will make it to the female's egg. However, patients can overcome this obstacle by undergoing desensitization procedures and/or artificial insemination.

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.